Understanding Parkinson’s Disease: From Symptoms to Treatment Approaches

Parkinson’s disease is a neurodegenerative disorder caused by the deterioration of nerve cells in the substantia nigra region of the midbrain. These nerve cells produce an essential chemical called dopamine, which plays a crucial role in controlling body movements, emotions, and cognitive functions. When these nerve cells degenerate, dopamine production decreases, leading to Parkinson’s disease. Additionally, Parkinson’s disease may also affect mood, memory, and other non-motor functions.

Since Parkinson’s disease results from progressive nerve cell degeneration, symptoms tend to worsen over time. Although there is currently no cure, various treatment options are available that can be tailored to each patient’s symptoms to improve their quality of life

Causes of Parkinson’s Disease

Parkinson’s disease does not have a single cause but is believed to result from a combination of factors, such as:

• Genetics: More common in individuals who develop symptoms at a younger age (diagnosed before 50 years old)
• Environmental Factors: Long-term exposure to certain toxins, such as pesticides and specific chemicals, may contribute to the disease

Recognizing Symptoms of Parkinson’s Disease

Symptoms of Parkinson’s disease are classified into two main groups:

• Motor Symptoms (Movement-related Symptoms)
  • Resting Tremor: Shaking of the hands, legs, or other body parts when at rest
  • Bradykinesia: Slowness of movement
  • Rigidity: Stiffness of muscles
  • Gait Disturbance: Abnormal walking patterns
  • Postural Instability: Difficulty maintaining balance
• Non-Motor Symptoms (Symptoms not related to movement, which are less visible)
  • Loss of Smell (Anosmia)
  • REM Sleep Behavior Disorder: Acting out dreams or sudden movements during sleep.
  • Constipation
  • Anxiety and Depression
  • Fatigue and Weakness
  • Cognitive and Memory Problems

Diagnosis of Parkinson’s Disease

Diagnosis is based on medical history, physical examination, and brain imaging to rule out other conditions with similar symptoms. In some cases, additional tests, such as dopamine transporter scans (DaTscan) or F-DOPA PET scans, may be required to confirm the diagnosis.


 

Treatment Options for Parkinson’s Disease

Treatment is divided into two main approaches:

1. Medication
   • Since Parkinson’s disease is caused by dopamine deficiency, medications focus on replenishing dopamine levels.
   • Common medications include levodopa and dopamine agonists.
2. Device-Aided Therapies
   • Initially, most patients respond well to medication. However, as the disease progresses, responses may become inconsistent, leading to motor fluctuations, wearing off (when medication effects fade quickly), or dyskinesia (involuntary movements caused by medication use). When medications become less effective, the following treatments may be considered:
   • Continuous Apomorphine Subcutaneous Infusion
     • Apomorphine is administered continuously under the skin to maintain stable dopamine levels and reduce symptoms such as wearing off.
     • This treatment requires an initial 7-10 day hospital stay to adjust the dosage.
   • Deep Brain Stimulation (DBS)
     • A surgical procedure where electrodes are implanted in the brain’s movement control regions. These electrodes are connected via subcutaneous wires to a pulse generator (similar to a pacemaker), which is implanted under the skin near the collarbone or abdomen.
     • DBS is recommended for patients whose symptoms no longer respond well to medication or resist to the oral medication. The treatment aims to reduce tremors, slow movements, muscle rigidity, and dyskinesia.
     • Patients must not have severe balance issues, advanced dementia, or serious mood disorders. Additional evaluations by specialists are necessary before considering this treatment.

 

Specialized Care at the Bumrungrad Neuroscience Center

The Bumrungrad Neuroscience Center provides comprehensive care for patients with Parkinson’s disease and movement disorders. A team of experienced specialists offers personalized treatment plans at all stages of the disease, helping patients maintain independence and achieve a better quality of life.